biliary system and diseases

Question 1

how are bile acids synthesized in the liver?

Answer 1

cholesterol to cholestanoic acid then cholanoic acid

Question 2

how are primary bile acids modifies in intestines?

Answer 2

by intestinal bacteria to secondary bile acids

Question 3

what is cholelithiasis?

Answer 3

gallstones
supersaturation of bile with cholesterol
delayed emptying of gallbladder

Question 4

symptoms of gallstones?

Answer 4

episodic pain in right upper quadrant
radiating pain to back

Question 5

what is choledocholithiasis?

Answer 5

presence of gallstones within common bile duct

Question 6

what is acute cholecystitis?

Answer 6

inflammation of gallbladder

Question 7

what is cholangitis?

Answer 7

inflammation of bile ducts commonly caused by polymicrobial bacterial infection

Question 8

symptoms of cholangitis?

Answer 8

persistent pain
Charcot’s triad - fever, jaundice, pain
elevated temp

Question 9

4 causes of gallstones?

Answer 9

• high cholesterol and not enough bile salts
• poor gallbladder contraction
• presence of proteins in liver
• increased oestrogen

Question 10

what is cholecystectomy?

Answer 10

key hole surgery to remove gallstones

Question 11

what is oral dissolution therapy?

Answer 11

oral natural bile acid UDCA

Question 12

drug that reduce intestinal cholesterol absorption?

Answer 12

ezetimibe
blocks NPC1L1 and cholesterol absorption
no effect on bile

Question 13

what is combined inhibition of gallbladder cholesterol?

Answer 13

statin and ezetimibe together
lower statin dose - reduced adverse effects